Klinkhammer Brent, Vadali Sirisha, Albulushi Arif, Burdorf Adam
Division of Cardiology, University of Nebraska Medical Center, Nebraska, USA.
Division of Cardiovascular Medicine, University of Missouri-School of Medicine, Missouri, USA.
Oman Med J. 2021 Jan 31;36(1):e230. doi: 10.5001/omj.2021.22. eCollection 2021 Jan.
Spontaneous coronary artery dissection is a serious and underreported clinical entity strongly associated with fibromuscular dysplasia (FMD). The female predominance of FMD may predispose many women to coronary artery dissection or other similar vascular pathologies. We present a case of a young woman who presented with a clinical tetrad of spontaneous coronary artery dissection, cardiogenic shock requiring extracorporeal membrane oxygenation, internal carotid dissections, and subacute cerebellar infarct secondary to underlying FMD. The patient's clinical course and vascular pathology are discussed. A review of the relevant literature of previously published similar cases, the incidence of spontaneous coronary artery dissection, and issues in the clinical management of spontaneous coronary artery dissection are also included.
自发性冠状动脉夹层是一种严重且报告不足的临床病症，与纤维肌发育不良（FMD）密切相关。FMD在女性中更为常见，这可能使许多女性易患冠状动脉夹层或其他类似的血管病变。我们报告一例年轻女性病例，该患者出现了自发性冠状动脉夹层、需要体外膜肺氧合的心源性休克、颈内动脉夹层以及继发于潜在FMD的亚急性小脑梗死这一临床四联征。讨论了该患者的临床病程和血管病理。还纳入了对先前发表的类似病例的相关文献回顾、自发性冠状动脉夹层的发病率以及自发性冠状动脉夹层临床管理中的问题。
